Evidence map›Paper›PMID 41786464›Full record

Observational studyRMD open2026

Effectiveness of TNF inhibitors in patients with very early axial spondyloarthritis, defined as duration of ≤1 year of back pain: longitudinal observational data from the SCQM registry.

Mauro Bachmann, Andrea Götschi, Annik Steimer, Jonas Brändli, Kristina Bürki, Michael Andor, Claudia Lourenço Rodrigues, Simon Grosswiler, Martin Wendiggensen, Diego Kyburz and 9 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Mauro BachmannDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland.
Andrea GötschiSwiss Clinical Quality Management in Rheumatic Diseases Foundation, Zürich, Switzerland.
Annik SteimerDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0009-0009-5896-2230
Jonas BrändliSwiss Clinical Quality Management in Rheumatic Diseases Foundation, Zürich, Switzerland.
Kristina BürkiDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0009-0009-1686-3875
Michael AndorRheumatologie im Zürcher Oberland, Uster, Switzerland.
Claudia Lourenço RodriguesSwiss Clinical Quality Management in Rheumatic Diseases Foundation, Zürich, Switzerland.
Simon GrosswilerAnkylosing Spondylitis Association, Zürich, Switzerland.
Martin WendiggensenJohns Hopkins University School of Advanced International Studies, Washington, DC, USA.
Diego KyburzDepartment of Rheumatology, University Hospital Basel, University of Basel, Basel, Switzerland.
Michael J NissenDepartment of Rheumatology, Geneva University Hospital, Geneva, Switzerland.
Burkhard MöllerDepartment of Rheumatology and Immunology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0001-8769-6167
Sabine AdlerDepartment of Rheumatology and Immunology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Diana DanDepartment of Rheumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Frauke FörgerDepartment of Rheumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Oliver DistlerDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0000-0002-0546-8310
Sofia RamiroDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-8899-9087
Raphael MicheroliDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0000-0002-8918-7304
Adrian CiureaDepartment of Rheumatology, Zürich University Hospital, University of Zürich, Zürich, Switzerland adrian.ciurea@usz.ch.ORCID 0000-0002-7870-7132

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo characterise patients with 'very early' axial spondyloarthritis (axSpA), defined as a duration ≤1 year of back pain and to determine the effectiveness of a first tumour necrosis factor inhibitor (TNFi) in very early versus established axSpA in a large observational registry.

methodsWe included a total of 3324 patients with axSpA from the Swiss Clinical Quality Management in Rheumatic Diseases registry with available data on duration of back pain (≤1 year=very early axSpA, n=441; >1 year and ≤2 years=early axSpA, n=218; >2 years=established axSpA, n=2575). A first TNFi was started in 31%, 38% and 36% of patients with very early, early and established axSpA. Adjusted logistic regression models were used to compare the probability of achieving low disease activity status according to the Axial Spondyloarthritis Disease Activity Score (ASDAS <2.1) at 1 year. Drug survival was analysed with multiple-adjusted Cox proportional hazards models. Missing data were handled using multiple imputation by chained equations.

resultsObjective signs of inflammation were more prevalent in very early disease. No difference was found regarding the achievement of ASDAS <2.1 after adjustment for age, sex, human leucocyte antigen-B27 status, education, body mass index, smoking, ASDAS and sacroiliac inflammation on MRI (OR 1.08, 95% CI 0.70 to 1.68 in very early vs established axSpA). Similarly, no significant difference in TNFi retention was found in very early versus established axSpA (HR for drug discontinuation 1.05, 95% CI 0.84 to 1.31).

conclusionWe found no evidence for a better effectiveness of TNFi in patients with very early versus established axSpA.

Indexed as

Axial SpondyloarthritisBack PainTumor Necrosis Factor InhibitorsAdultFemaleHumansLongitudinal StudiesMaleMiddle AgedRegistriesSeverity of Illness IndexSwitzerlandTime FactorsTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor-alphaTumor Necrosis Factor Inhibitorsaxial spondyloarthritisbiological therapytumor necrosis factor inhibitors

Identifiers

PMID41786464
PMCPMC12970104

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.